Table 2.

A comprehensive communication framework that includes the 5Ts to address practical research issues and the 5Ms to describe relevant geriatric principles

Domain	Description	Example recommendations to address challenges
Target population	“At risk” or “real-world” population	• Avoid exclusions that limit study generalizability • Understand the prevalence of the studied condition in older adults
Team	Research team Family, informal caregivers	• Engage geriatrician researchers and aging experts • Connect with caregivers and community resources
Tools	Measurement tools used in aging research	• Choose appropriate measures of function, physical performance, patient-reported outcomes, and the like • Balance data collection needs and participant burden
Time	Participant and study time	• Anticipate longer study visits for some participants • May need to accommodate comorbidities during long study visit days (e.g., snacks for diabetics, inform participants to bring afternoon medications) • May take longer to schedule follow-up visits if participants are dependent on others for transportation or scheduling
Tips to accommodate	Suggestions for improving recruitment and retention	• Budget for door-to-door transportation • Use pocket talkers, high-contrast print materials, large font size • Plan for higher attrition rate, which has implications for sample size/power calculations
Mind	Cognitive impairment Dementia Depression	• Consider cognition when assessing for capacity to provide informed consent • Simplify study procedures • Include caregivers/proxy respondents
Mobility	Mobility limitations Restricted community mobility Functional limitations/Disability	• Ensure access to study location • Schedule home visits or alternatives for those with mobility limitations • Include caregivers/proxy respondents
Medications	Polypharmacy Drug-drug interactions Adverse events	• Review non-study medications • Discontinue potentially inappropriate medications • Anticipate common adverse events
Multi-complexity	Multiple chronic conditions Multiple age-related impairments Personal and environmental factors that contribute to complexity	• Limit exclusions to maximize representativeness • Account for competing risks • Address trade-offs that occur in context of competing priorities
Matters most to me	Patient-centered outcomes	• Include outcomes that are important to patients such as function • Include other stakeholders (e.g., family/caregivers, health system)